title: A longitudinal assessment of lipids in youth with type 1 diabetes.
abstract: BACKGROUND
  Type 1 diabetes and dyslipidemia are known risk factors for cardiovascular disease (CVD), but the relationship between lipid levels in youth with type 1 diabetes and future CVD remains unknown.
  
  
  OBJECTIVE
  To characterize lipid levels and CVD risk factors over time in youth with type 1 diabetes.
  
  
  METHODS
  The study included adolescents with type 1 diabetes (12-25 yr) with a minimum of 3-yr follow-up.
  
  
  METHODS
  A longitudinal prospective, observational study of 46 youth with type 1 diabetes was performed. Fasting lipid profiles, A1C, and body mass index (BMI) were measured every 6 months for at least 3 yr (median 4.2 yr). Low-density lipoprotein (LDL)-cholesterol, total cholesterol (TC), and triglycerides (TG) were divided into categorical variables.
  
  
  RESULTS
  At baseline, median age was 14.3 yr, mean diabetes duration was 6.4 ± 3.8 yr, mean A1C was 8.1 ± 1.0%, and median BMI z-score was 0.92. Fifty percent of subjects had LDL levels ≤ 100 mg/dL (≤ 2.6 mmol/L) at study onset. After adjusting for confounding factors, increasing BMI z-score [β = 0.2, 95% confidence interval (CI ) = 0.03-0.38, p = 0.03] and increasing A1C (β = 0.18, 95% CI = 0.08-0.29, p = 0.001) were associated with increasing LDL category over time. Non-Hispanic ethnicity (β = 0.45, 95% CI = 0.12-0.79, p = 0.008) and family history of stroke (β = 0.38, 95% CI = 0.04-0.72, p = 0.03) were also associated with increasing LDL category. Age, diabetes duration, and tobacco exposure were not related to change in LDL. Increasing A1C was associated with increases in TG (β = 18.1, 95% CI = 2.3-33.9, p = 0.03), TC (β = 20.3, 95% CI = 9.0-31.5, p < 0.0001), and LDL (β = 13.4, 95% CI = 3.17- 23.6, p = 0.01).
  
  
  CONCLUSIONS
  Glycemic control and BMI are modifiable risk factors for dyslipidemia in youth with type 1 diabetes.
authors.affiliation: Center For Endocrinology, Diabetes, and Metabolism, Childrens Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA 90027, USA
authors.forename: Christina M Southern
authors.initials: CM
authors.lastname: Reh
authors.forename: Steven D
authors.initials: SD
authors.lastname: Mittelman
authors.forename: Choo-Phei
authors.initials: CP
authors.lastname: Wee
authors.forename: Avni C
authors.initials: AC
authors.lastname: Shah
authors.forename: Francine R
authors.initials: FR
authors.lastname: Kaufman
authors.forename: Jamie R
authors.initials: JR
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D002648:Child; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D050171:Dyslipidemias / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006630:Hispanic or Latino; D006801:Humans; D050356:Lipid Metabolism; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human